Question Question 1 Which of the following is found in tertiary syphilis? Question options: 1) arthralgia 2) lymphadenopathy 3) macular or papular lesions involving the palms and soles 4) gumma Question 2 The Pap test should not be considered a screening test for STDs Question options: 1) True 2) False Question 3 During a breast exam you note all of the findings below as normal except: Question options: 1) asymetrical size 2) a supernumerary nipple 3) hyperpigmentation 4) breasts that move up symmetrically with raising the arms Question 4 A female patient who has not reached menarche by age 15 should be considered for a diagnosis of Question options: 1) oligomenorrhea 2) amenorrhea 3) primary amenorrhea 4) secondary amenorrhea Question 5 A 24-year-old woman presents with a 1-week history of thin, green-yellow vaginal discharge with perivaginal irritation Physical examination findings include vaginal erythema with petechial hemorrhages on the cervix, numerous white blood cells, and motile organisms on microscopic examination These findings most likely represent: Question options: 1) motile sperm with irritative vaginitis 2) trichomoniasis 3) bacterial vaginosis 4) condyloma acuminatum

Question 1: Which of the following is found in tertiary syphilis?
Answer: The correct answer is 4) gumma.

Tertiary syphilis is the late stage of syphilis, which can occur years or even decades after initial infection. It is characterized by the development of gummas, which are soft, tumor-like swellings that can occur in various tissues of the body. Gummas can develop on the skin, bones, liver, heart, and other organs. They are typically painless and can cause tissue damage and destruction if left untreated.

Arthralgia (joint pain) and lymphadenopathy (swollen lymph nodes) are more commonly seen in the early stages of syphilis. Macular or papular lesions involving the palms and soles are seen in secondary syphilis, which occurs a few weeks to a few months after initial infection.

Question 2: The Pap test should not be considered a screening test for STDs.
Answer: The correct answer is 2) False.

The Pap test, also known as a Pap smear, is a screening test for cervical cancer, but it can also detect certain sexually transmitted infections (STIs) such as human papillomavirus (HPV). During a Pap test, cells are collected from the cervix and examined under a microscope for any abnormalities.

While the Pap test is primarily used for cervical cancer screening, it can also provide information about certain STIs. However, it is important to note that the Pap test is not a comprehensive screening test for all STIs. Other tests, such as swabs or blood tests, may be needed to screen for other STIs like chlamydia, gonorrhea, or syphilis.

Question 3: During a breast exam, you note all of the findings below as normal except:
Answer: The correct answer is 1) asymmetrical size.

During a breast exam, it is generally considered normal for breasts to be asymmetrical in size and shape. Many women have breasts that are slightly different in size, and this is usually not a cause for concern.

A supernumerary nipple is an extra nipple, which is also considered a normal variation. It is estimated that 1-5% of the population may have supernumerary nipples. Hyperpigmentation refers to increased pigmentation or darkening of the skin, which can also be normal in certain individuals. Breasts that move up symmetrically with raising the arms are an expected finding during a breast exam.

Question 4: A female patient who has not reached menarche by age 15 should be considered for a diagnosis of:
Answer: The correct answer is 3) primary amenorrhea.

Primary amenorrhea is defined as the absence of menstruation by age 15 in the presence of normal growth and secondary sexual characteristics, or the absence of menstruation by age 13 in the absence of normal growth and secondary sexual characteristics. It can be caused by various factors, such as hormonal imbalances, structural abnormalities of the reproductive system, genetic disorders, or certain medical conditions.

Oligomenorrhea refers to infrequent or irregular menstrual periods. Secondary amenorrhea is the absence of menstruation for a period of at least three cycles in a woman who has previously had regular periods. It can occur due to factors such as pregnancy, hormonal imbalances, stress, excessive exercise, or certain medical conditions.

Question 5: A 24-year-old woman presents with a 1-week history of thin, green-yellow vaginal discharge with perivaginal irritation. Physical examination findings include vaginal erythema with petechial hemorrhages on the cervix, numerous white blood cells, and motile organisms on microscopic examination. These findings most likely represent:
Answer: The correct answer is 2) trichomoniasis.

Trichomoniasis is a sexually transmitted infection caused by the protozoan parasite Trichomonas vaginalis. It is characterized by symptoms such as vaginal discharge (often thin and frothy), perivaginal irritation, itching, and sometimes a foul odor. The discharge may be yellow-green in color.

On physical examination, findings of vaginal erythema (redness) with petechial hemorrhages (small, pinpoint bruises) on the cervix, numerous white blood cells, and motile organisms on microscopic examination are suggestive of trichomoniasis. A definitive diagnosis can be made by a laboratory test that detects the presence of Trichomonas vaginalis in vaginal fluid samples.

Bacterial vaginosis is another common cause of vaginal discharge, but it typically presents with a grayish-white, fishy-smelling discharge and is associated with an overgrowth of certain bacteria in the vagina. Motile sperm with irritative vaginitis is an unlikely scenario, as sperm usually does not cause significant irritation or symptoms. Condyloma acuminatum refers to genital warts, which are caused by certain strains of the human papillomavirus (HPV). It typically presents as soft, fleshy growths on the genital area and does not cause vaginal discharge.